Frostbite

Frostbite

Alternate Names

Definition

Frostbite occurs when exposure to extremely cold temperatures damages the skin or other tissues.

Risks

What are the causes and risks of the injury?

Anyone who is exposed to extreme cold for a significant length of time has a risk of developing frostbite. Windy weather may contribute to frostbite, too, by blowing body heat away from the body.

Frostbite occurs more often among:

those who work outside or exercise (such as skiers and runners) in extremely cold areas

mountain climbers

people who are caught in the elements without proper clothing

people taking certain medications, such as beta-blockers, that decrease the blood flow to the skin

smokers

people who have blocked arteries, atherosclerosis or other problems that affect blood circulation

people with diabetes

people with nerve problems that decrease their ability to feel injuries in certain parts of the body, a condition called neuropathy

Prevention

What can be done to prevent the injury?

Prevention is the key to avoiding frostbite. When a person is in very cold areas for long periods of time, he or she should:

stop smoking and drinking alcohol

wear warm, multilayered, dry clothing (cotton is best, as opposed to wool) that fits loosely, as tight clothes tend to be less warming and can cut down circulation. Some materials are designed to wick moisture away from the skin; an important factor in athletes who sweat.

avoid high altitude, windy areas

stay warm through activity

take necessary precautions to prevent cold exposure

If a person should get wet in cold weather, it is important to dry off quickly and change clothes right away.

Diagnosed

How is the injury recognized?

Usually, a healthcare professional diagnoses frostbite if:

a person reports exposure to extreme cold and a feeling of pins and needles followed by numbness

skin in the injured area has a change in color or thickness

Treatments

What are the treatments for the injury?

If a person may have frostbite, it is important to:

bring him or her to a warmer spot

remove any wet or constricting clothing

thaw the area by putting it into warm water that is less than 110 degrees F for at least 20 minutes, if possible. This thawing may cause the affected person pain or discomfort, but it is important.

apply gauze dressings to the frostbitten area, if available, wrapping each toe or finger separately

move the area as little as possible

try to keep the area warm so that it will not freeze again

seek medical attention

There are several things to avoid when treating frostbite. A person should not:

rub or massage the affected area

break any blisters that are present

use hot water or direct heat such as hair dryers, radiators or fires to warm the frostbitten areas

A healthcare professional will continue treatment as needed. Pain and infection of the infected skin areas are fairly common problems from the injury. Pain may require prescription-strength pain medications in some cases. Antibiotics may be required for infection, which are usually given topically.

Surgical treatment may be needed in some cases, but is often delayed. This is because most severe cold injury is more superficial than it seems, and often causes less tissue loss than predicted. Sometimes the frostbitten areas are large or severe enough to require a skin graft or even amputation of the affected area.

Side Effects

What are the side effects of the treatments?

All medications cause side effects, such as allergic reactions or stomach upset. Surgery can be complicated by infection, bleeding or an allergic reaction to the anesthetic.